One of the most difficult and anxiety provoking aspects of caring for an elderly loved one is the initial conversation about whether they need care. These conversations are so difficult because emotions and passions are involved as well as traditional familial roles and history. Normally, the caregiver is concerned about their parent’s health and well-being while the parents (care recipients) are concerned about maintaining their independence and dignity. Given this dynamic, the conversations can become emotionally charged and difficult.

The “Care-giving” conversation with our elderly loved ones is always difficult and because of that difficulty we tend to put it off until a crisis occurs and we are forced to confront it head on. In most cases we don’t think about what additional care our parents will need until we absolutely must. But, avoidance is no defense. As former first lady Rosalyn Carter once said, “there are only four kinds of people in this world: those who have been caregivers; those who currently are caregivers; those who will be caregivers; and those who will need caregivers.” Nearly all of us will have to deal with “care-giving” for ourselves our parents, relatives, friends, or neighbors.

Most people don’t like to admit when they need help and this situation is only exacerbated because the intended care recipient also sees the need for assistance as yet another tacit reminder of their own mortality. Convincing the elderly to first acknowledge the need for help; and then second engage in a conversation on the topic can be very difficult and frustrating. To put this in context, many people who’ve had conversations both with their kids regarding sex/drugs/alcohol, and their parents regarding the need for “care” have said that the conversations with the parents were far more difficult and stressful. Maybe worst of all, this is likely only the first in a series of difficult discussions that will take place as your loved ones age.

Given the difficulties and emotional sensitivities, most people put off these discussions until a crisis mandates them. Sometimes, the catalyst is a major medical crisis (heart attack, stroke, severe fall, etc.); other times, it is something more subtle (noticeable loss of memory, change in temperament, or excessive amounts of laundry or bills piling up). While these examples may not be conclusive, they are warning signs that help/care may be needed. If people ignore the warning signs until a crisis necessitates that they get help frequently a less than optimal decision is made because they are reacting to the situation and struggling to find a workable solution to the immediate problem.

Communication styles brought on by generational differences can lead to another potential source of conflict. For example, the younger generation – possibly due to excessive “over-scheduling” – wants to “get right to the point” and tackle the issue head-on, while their elders want to talk and reminisce about the old days and any other topic that comes to mind. For the younger person trying to help, this can be extremely frustrating and confusing (side note: this communication disconnect can sometimes lead to the erroneous belief that the elderly person is experiencing some form of cognitive decline.) When engaging in these conversations each side must make significant efforts to understand the perspective of the other person.

Given the difficulties inherent in these conversations and because of differing communication styles, here are a few suggestions to help move the conversation forward:

1) Go into the conversations with a lot of patience – some things can not be rushed.

2) Ask open ended questions (as distinguished from making statements).

3) Be careful of your word choice and tone, an elder may focus on the word choice or tone as a diversion to avoid focusing on the main issue of whether they require assistance with routine daily activities.

4) You have your perspective and they have theirs; understand that while you may be speaking about the same circumstance or event you may see things very differently. In this case it is not who is wrong or right, the important thing is to respect each other’s positions. Come together and find an acceptable solution for everyone involved.

5) Understand there may be generational role expectations that impede your progress. For example, while you are pressing your parent because you love/care for them and are concerned about their well being, they (because they’re from the “strong/silent” generation where people don’t publicly discuss their problems ) may tell you the questions you are asking are “none of your business”. Don’t let this deter you. Find a way to speak to them such that you illicit the information you need while allowing them to preserve their dignity.

Having these conversations with your loved ones, while extremely difficult, may also be extremely rewarding. You as the caregiver will feel good that you are able to help loved one and repay the good care that they provided you as a child. Even if they never say it (remember, they are the strong/silent generation), they will appreciate it and love you all the more for it. Good luck.

Derrick Y. McDaniel is the Managing Director of Caring Hearts of New Jersey Home Care, located at 4 South Orange Ave., #302, South Orange, NJ 07079. Phone – 973-532-2713. www.caringheartsnj.com